The inferior mesenteric vein drains the hindgut derivatives, joining the splenic vein behind the pancreatic neck. Portal hypertension reverses flow in the IMV — the left gastric (coronary), IMV, and paraumbilical veins become the main portosystemic collateral channels producing oesophageal and anorectal varices. The IMV is divided during left hemicolectomy and sigmoid resection.
| Origin | Drains the left colon, sigmoid, and superior rectum |
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The IMV serves as a landmark during left colon dissection — dividing it at the inferior pancreatic border during sigmoid resection allows medial mobilisation of the left colon. In left hemicolectomy, ligation of the IMV at the pancreatic border with the IMA at its aortic origin provides oncologically adequate resection margins with good mesenteric reach for anastomosis.
IMV division as a planned step in sigmoid resection and left hemicolectomy to facilitate medial colon mobilisation.
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